Provider Field Representative - Remote Central California

Gainwell Technologies LLC•Any city, OH

3d•$70,000 - $75,000•Remote

About The Position

Gainwell Technologies is seeking an experienced Provider Field Representative to support healthcare providers throughout Central California as part of California’s Medi-Cal program. In this role, you will serve as a primary point of contact for healthcare providers within an assigned Central California geographic territory. You will conduct virtual and onsite provider visits, deliver training and education, research claims and billing issues, and help providers understand Medi-Cal policies, procedures, and program requirements. You will work directly with providers, provider associations, internal Gainwell teams, and client representatives to resolve issues, identify provider needs, and improve the overall provider experience. Candidates must reside in Central California and be willing and able to travel throughout their assigned territory. The territory may include Fresno, Kern, Tulare, Kings, Madera, Merced, Stanislaus, San Joaquin, Monterey, and San Luis Obispo counties, as well as surrounding areas based on business needs.

Requirements

Three or more years of experience in provider relations, provider outreach, provider education, healthcare operations, healthcare claims, Medicaid/Medi-Cal, healthcare consulting, business process outsourcing, or a related healthcare function.
Experience working directly with healthcare providers, provider offices, medical groups, healthcare organizations, or other healthcare stakeholders.
Experience delivering training, presentations, workshops, webinars, or educational sessions in both virtual and in-person environments.
Experience researching and resolving healthcare claims, billing, payment, provider enrollment, or other provider-related operational issues.
Strong communication, presentation, facilitation, relationship-management, and customer service skills.
Strong analytical, organizational, and time-management skills with the ability to independently manage an assigned geographic territory.
Willingness and ability to travel throughout an assigned Central California territory, including limited overnight travel as business needs require.
Reliable high-speed internet connectivity is required for work-from-home responsibilities.

Nice To Haves

Medi-Cal or Medicaid experience is preferred.

Responsibilities

Build and maintain strong working relationships with healthcare providers and provider organizations throughout an assigned Central California territory.
Conduct virtual and onsite provider visits to provide education, training, operational support, and assistance with Medi-Cal program requirements.
Develop and deliver provider training through workshops, seminars, webinars, one-on-one sessions, and other virtual and in-person educational events.
Provide one-on-one billing support and research healthcare claims, payment, and provider-related issues to help identify and resolve concerns.
Serve as a liaison between healthcare providers, provider associations, internal Gainwell departments, and client representatives.
Apply established Medi-Cal policies, procedures, and program requirements to research and resolve provider questions and operational issues.
Identify provider trends, recurring issues, and opportunities for additional education or process improvement and communicate findings to leadership.
Exercise independent judgment within established guidelines while escalating complex or sensitive issues as appropriate.